Cardiology: right-sided endocarditis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: right-sided endocarditis

Sample item

An intravenous drug user has fever, multiple cavitating nodules on chest X-ray and a pansystolic murmur at the left lower sternal border that increases with inspiration. Which valve is involved?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Tricuspid valve

Injection drug use favours right-sided endocarditis, usually tricuspid and often due to S. aureus. Septic pulmonary emboli produce multiple peripheral cavitating nodules. Tricuspid regurgitation murmurs increase with inspiration (Carvallo sign).

Option by option

  • A. Tricuspid valve (correct)

    Correct. Tricuspid involvement explains septic emboli and the Carvallo sign.

  • B. Aortic valve

    Aortic involvement causes peripheral emboli and AR murmur.

  • C. Mitral valve

    Mitral involvement is more typical in rheumatic disease.

  • D. Pulmonary valve

    Isolated pulmonary valve endocarditis is rare.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Tricuspid valve. Injection drug use favours right-sided endocarditis, usually tricuspid and often due to S.

Why is "Aortic valve" not the answer?

Aortic involvement causes peripheral emboli and AR murmur.

Why is "Mitral valve" not the answer?

Mitral involvement is more typical in rheumatic disease.

Why is "Pulmonary valve" not the answer?

Isolated pulmonary valve endocarditis is rare.

What concept does this question test?

It tests Cardiology: right-sided endocarditis in General Medicine. aureus. Septic pulmonary emboli produce multiple peripheral cavitating nodules. Tricuspid regurgitation murmurs increase with inspiration (Carvallo sign).

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: right-sided endocarditis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.